Healthcare Provider Details

I. General information

NPI: 1710853577
Provider Name (Legal Business Name): MELINA GRACE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 QUEBEC ST BLDG 400
DENVER CO
80230-7145
US

IV. Provider business mailing address

200 QUEBEC ST BLDG 400
DENVER CO
80230-7145
US

V. Phone/Fax

Practice location:
  • Phone: 303-340-4459
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0025685
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: